Kidney stones are quite common, occurring in 8.8% of the population. They are also quite painful. Just ask Andrew Rogers, 33, of Raynham, Mass., who had them a year ago and says, "I hope to avoid the experience again, as it was the worst pain I have ever been through."
Kidney stones are collections of crystals that can form in the urine from salts from foods. They develop in the kidney and are often eliminated from the body along with urine.
"But if the stones become too large, they can block the urinary system while trying to pass through," says Angelo Cambio, MD, an urologist with Urologic Specialists of New England who practices at Kent Hospital.
Dehydration is the leading cause of kidney stones. "Dehydration causes urine to be concentrated and increases the chances of crystals developing and forming into stones," Dr. Cambio explains.
Diets that are high in animal protein and salt also increase the chance that kidney stones will develop. Some people have alterations in how they process salts that can increase their risk for stone formation. Risk also increases with a sedentary lifestyle, obesity, chronic diarrhea, and urinary tract infection.
Small, non-obstructing stones are not an urgent problem. But stones that fail to pass can be a serious problem.
"Obstructing stones can cause a decline in kidney function, pain, nausea, and vomiting," Dr. Cambio says.
In fact, stones that are obstructing and associated with signs of infection such as fever are an emergency and can be life threatening. Large stones that are not blocking drainage of the kidney can be associated with recurrent urinary tract infection and a decline in kidney function over time.
Rogers' first symptom was blood in his urine. A scan showed he had stones that weren't being passed. A few months later, he had extreme pain in his lower back accompanied by blood in his urine once again. At that point, he returned to the hospital for full diagnosis and treatment.
Symptoms and Treatments
Stones that do not block the flow of urine from the kidney to the bladder often have no symptoms. But obstructing stones can cause severe back/side pain, nausea, vomiting, blood in the urine, and/or pain in the groin or genitals, Dr. Cambio says. Fever and shaking chills can be a sign of an associated infection and warrant emergency medical intervention. Symptoms can be confirmed with a CT scan, ultrasound, or x-ray.
Medical expulsive therapy is the use of medicines to control symptoms and facilitate the passage of small stones. Urine is strained to confirm that the stones have passed.
Treatment options - determined by the patient’s health, stone size, and position - include:
Extacorporeal shockwave lithotripsy, the use of x-ray to target stones that are then treated with ultrasound energy so they break up and pass
Ureteroscopy, a procedure by an urologist who inserts telescopes and cameras into the urinary system to find the stone, break it up with a laser fiber, and remove fragments with a basket
Percutaneous nephrolithotomy, used for larger stones in the kidney, this is when an urologist enters the kidney through a small incision on the patient's back to remove the stone
Rogers' stones were surgically removed with ureteroscopy because they were too large to pass.
To prevent kidney stones, stay well hydrated. Ideally, you will produce 2.5 to 3 liters of urine a day. Minimize salt and animal protein. Increasing your intake of citric acid (lemons and limes) can also prohibit stone formation.
An urologist can order urine and blood testing to make other recommendations for people prone to kidney stones. For some, a low oxalate diet can help. Oxalate is a molecule that comes from plants, fruits, seeds, and nuts, like spinach, chard, beets, chocolate, nuts, and berries"
Dr. Cambio believes I ate too much food containing oxalates," says Rogers, who promptly made some dietary changes.